Abstract: :
Purpose:dynamic Indocyanine Green Angiography (d–ICGA)has becoming increasingly important for the early diagnosisof RAP, often misinterpreted as type 1 (vascularized pigmentepithelial detachment – PED) or type 2 (late leakage ofundetermined source) occult CNV in patients with ARMD. Purpose of this study was to ascertain the prevalence of RAPin patients with ARMD and occult CNV by means of d–ICGA.Methods:we reviewed the clinical data of 253 consecutive patients(270 eyes) with a clinical diagnosis of type 1 or type 2 occultCNV on fluorescein angiography (FA) evaluated at our institutionbetween 1998 and July 2003. All of them were examined with sequentialdigital fluorescein and ICG angiograms using a confocal scanninglaser ophthalmoscope (Heidelberg Retinal Angiograph, HeidelbergEngeneering Gmbh, Germany).Results:of 253 patients, 165 were women (65%) and 83 were men(35%). The mean age was 70 years. 60 eyes (22%) had a vascularizedPED (type 1) and 210 (78%) a type 2 occult CNV with d–ICGA.We identified 57 RAP in 54 eyes (21%). The RAPs were in 6 of60 eyes with type 1 (10%) and 51 of 210 eyes with type 2 occultCNV (24%). The mean distance of the lesions from the fovea was682 ± 304 µm (mean ± SD). In 47 % of thecases the RAP was located inferior to the fovea, in 33% superiorand in 10.5% of the cases temporal to the fovea. RAPs were visible only with d–ICGA in 65% of the patientsexamined whereas they were also visible on FA in 21% of thecases. The mean dimension of the RAP was 668 ± 453 µm(mean ± SD).Conclusions:our study shows the importance of d–ICGA forthe early diagnosis of RAP in exudative ARMD. In our series up to ¼ of type 2 occult CNV were in fact RAP. This is consistent with the only paper published in the literatureabout the prevalence of RAP in exudative ARMD (Axer–SiegelR. et al., Ophthalmology, 109: 1726, 2002).